Provider Demographics
NPI:1386203073
Name:C HOUSTON, INC
Entity Type:Organization
Organization Name:C HOUSTON, INC
Other - Org Name:EVOLVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLE
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-229-8321
Mailing Address - Street 1:7459 BOOKHAM CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6734
Mailing Address - Country:US
Mailing Address - Phone:435-229-8321
Mailing Address - Fax:
Practice Address - Street 1:4033 3RD AVE STE 400
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2140
Practice Address - Country:US
Practice Address - Phone:888-883-8658
Practice Address - Fax:888-606-1317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty